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Risk of invasive cervical cancer in relation to management of abnormal Pap smear results

Silfverdal, Lena ; Kemetli, Levent ; Andrae, Bengt ; Sparen, Par ; Ryd, Walter ; Dillner, Joakim LU ; Strander, Bjorn and Tornberg, Sven (2009) In American Journal of Obstetrics and Gynecology 201(2).
Abstract
OBJECTIVE: We sought to evaluate the management of women with abnormal cytology in terms of subsequent risk of invasive cervical cancer. STUDY DESIGN: The screening histories of all invasive cervical cancer cases diagnosed in Sweden 1999-2001 and of 5 population-based controls per case were reviewed. In all, 159 patients and 258 control subjects aged < 67 years had an abnormal smear result 0.5-6.5 years prior to cancer diagnosis. The cervical cancer risk was estimated in relation to management by calculating odds ratios. RESULTS: Histologic assessment of low-grade squamous abnormalities strongly reduced the risk compared to repeated cytology (odds ratio, 0.46; 95% confidence interval, 0.24-0.89). Delaying histologic assessment was also... (More)
OBJECTIVE: We sought to evaluate the management of women with abnormal cytology in terms of subsequent risk of invasive cervical cancer. STUDY DESIGN: The screening histories of all invasive cervical cancer cases diagnosed in Sweden 1999-2001 and of 5 population-based controls per case were reviewed. In all, 159 patients and 258 control subjects aged < 67 years had an abnormal smear result 0.5-6.5 years prior to cancer diagnosis. The cervical cancer risk was estimated in relation to management by calculating odds ratios. RESULTS: Histologic assessment of low-grade squamous abnormalities strongly reduced the risk compared to repeated cytology (odds ratio, 0.46; 95% confidence interval, 0.24-0.89). Delaying histologic assessment was also associated with a higher risk ( odds ratio, 5.65; 95% confidence interval, 1.39-23.05). After high-grade squamous atypia, absence of any cytologic or histologic specimen was a major determinant of cancer risk (odds ratio, 12.52; 95% confidence interval, 1.42-infinitive). CONCLUSION: For adequate protection against invasive cervical cancer, further assessment with histology must be recommended also for women with low-grade squamous abnormalities. (Less)
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author
; ; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
population-based case control study, smear results, repeated cytology, management of abnormal Pap, cervical cancer risk, histologic assessment
in
American Journal of Obstetrics and Gynecology
volume
201
issue
2
publisher
Elsevier
external identifiers
  • wos:000268460900022
  • scopus:67651087150
  • pmid:19560117
ISSN
1097-6868
DOI
10.1016/j.ajog.2009.04.006
language
English
LU publication?
yes
id
a321a67d-1d9e-4332-b3c4-e7d7da390a7d (old id 1460155)
date added to LUP
2016-04-01 12:30:38
date last changed
2020-01-12 09:57:45
@article{a321a67d-1d9e-4332-b3c4-e7d7da390a7d,
  abstract     = {OBJECTIVE: We sought to evaluate the management of women with abnormal cytology in terms of subsequent risk of invasive cervical cancer. STUDY DESIGN: The screening histories of all invasive cervical cancer cases diagnosed in Sweden 1999-2001 and of 5 population-based controls per case were reviewed. In all, 159 patients and 258 control subjects aged &lt; 67 years had an abnormal smear result 0.5-6.5 years prior to cancer diagnosis. The cervical cancer risk was estimated in relation to management by calculating odds ratios. RESULTS: Histologic assessment of low-grade squamous abnormalities strongly reduced the risk compared to repeated cytology (odds ratio, 0.46; 95% confidence interval, 0.24-0.89). Delaying histologic assessment was also associated with a higher risk ( odds ratio, 5.65; 95% confidence interval, 1.39-23.05). After high-grade squamous atypia, absence of any cytologic or histologic specimen was a major determinant of cancer risk (odds ratio, 12.52; 95% confidence interval, 1.42-infinitive). CONCLUSION: For adequate protection against invasive cervical cancer, further assessment with histology must be recommended also for women with low-grade squamous abnormalities.},
  author       = {Silfverdal, Lena and Kemetli, Levent and Andrae, Bengt and Sparen, Par and Ryd, Walter and Dillner, Joakim and Strander, Bjorn and Tornberg, Sven},
  issn         = {1097-6868},
  language     = {eng},
  number       = {2},
  publisher    = {Elsevier},
  series       = {American Journal of Obstetrics and Gynecology},
  title        = {Risk of invasive cervical cancer in relation to management of abnormal Pap smear results},
  url          = {http://dx.doi.org/10.1016/j.ajog.2009.04.006},
  doi          = {10.1016/j.ajog.2009.04.006},
  volume       = {201},
  year         = {2009},
}